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A crucial problem in healthcare is lack of information and lack of incentives. As I've arguedbefore, I believe the trend of constant monitoring, data capture, and analysis is likely to change this in a very important ways. A new story from Bloomberg shows us how this is already beginning:

You may soon get a call from your doctor if you’ve let your gym membership lapse, made a habit of picking up candy bars at the check-out counter or begin shopping at plus-sized stores.

That’s because some hospitals are starting to use detailed consumer data to create profiles on current and potential patients to identify those most likely to get sick, so the hospitals can intervene before they do.

Information compiled by data brokers from public records and credit card transactions can reveal where a person shops, the food they buy, and whether they smoke. The largest hospital chain in the Carolinas is plugging data for 2 million people into algorithms designed to identify high-risk patients, while Pennsylvania’s biggest system uses household and demographic data. Patients and their advocates, meanwhile, say they’re concerned that big data’s expansion into medical care will hurt the doctor-patient relationship and threaten privacy.

The rest of the story is fascinating and worth reading. I believe this is just the beginning. As Bloomberg reports, because of Obamacare, hospitals have strong incentives to utilize this data in productive ways. For example, hospital now face fines if their readmission rates are too high, and are rewarded if they "do well on a benchmark of clinical outcomes and patient surveys".

While I think this is important for hospitals, the incentives are even stronger for insurance companies. After some period of time, the hospital's patients are no longer their problem. But for insurance companies, a person's lifetime health costs and behaviors that may be increasing them are important drivers of costs. While Obamacare limits the extent that insurance companies could penalize people for unhealthy behaviors they observe in the data, I believe they can at least reward them for good behaviors. Of course the line between charging people more for unhealthy behavior and discounting them for healthy behavior is fuzzy. What if your insurance company gives you a $1,000 annual cash back "healthy behavior" reward that is slowly decreased by unhealthy behaviors? Would this be legal like a discount for using a gym membership or illegal like a penalty for being overweight?

Even within the clearly legal areas I think many people will find this monitoring creepy, as the Bloomberg story points out. But my guess is that aversion to being monitored is a norm that is currently changing and will continue to change in the future. I think the constant background assumption that the government can easily read your emails and and texts and listen to your calls will slowly reduce the dislike of invasiveness monitoring due to status quo bias alone. What's more the financial incentives for the monitoring with the highest economic net benefit and least invasiveness will be large and hard to resist. Once we succumb to this monitoring it will make us more used to being watched, which will make us less resistant to more invasive monitoring and less financial incentives. People who grow up with this will find past generations' aversion to being monitored strange to understand.

This change in norms is important to keep in mind when I tell you that future monitoring for our health and safety won't be limited to credit card transactions, but actual chips in our bodies. If you find grocery stores data-mining our purchases intolerably creepy, you may find yourself in a small panic imagining body implants that count your calorie consumption in real time.

Let me close by noting that I'm trying to discuss this issue with my personal judgements about whether this future will be good or bad aside; this is merely a prediction. I believe our future will be safer, healthier, and more efficient. It will also be a lot less private and a lot less free. Will our highly invasive and safe future be a dystopia or a utopia? I'll leave that assessment to others, but I do believe future generations will have vastly different judgements of this than most of us alive today will. My guess is millenials today are already far more accepting of being watched by technology than the rest of us. And this is just the beginning.